How much improvement in patient reported outcomes after isolated medial patellofemoral ligament reconstruction is associated with surgeon-defined satisfactory outcomes? A JUPITER study

IF 3.3 Q1 ORTHOPEDICS
Saral Patel MD , Matthew W. Veerkamp BA , Eric J. Wall MD , Philip L. Wilson MD , Daniel W. Green MD, MS, FAAP, FACS , Benton E. Heyworth MD , Natalie K. Pahapill BS , Beth E. Shubin Stein MD , Shital N. Parikh MD, FACS
{"title":"How much improvement in patient reported outcomes after isolated medial patellofemoral ligament reconstruction is associated with surgeon-defined satisfactory outcomes? A JUPITER study","authors":"Saral Patel MD ,&nbsp;Matthew W. Veerkamp BA ,&nbsp;Eric J. Wall MD ,&nbsp;Philip L. Wilson MD ,&nbsp;Daniel W. Green MD, MS, FAAP, FACS ,&nbsp;Benton E. Heyworth MD ,&nbsp;Natalie K. Pahapill BS ,&nbsp;Beth E. Shubin Stein MD ,&nbsp;Shital N. Parikh MD, FACS","doi":"10.1016/j.jisako.2025.100997","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>The extent of change in Patient Reported Outcome Measures (PROMs) required to meet surgeon-defined satisfactory outcomes after isolated medial patellofemoral ligament reconstruction (MPFL-R) has not been reported. The primary aim of the study was to define the threshold value of maximal outcome improvement (MOI) in PROMs associated with surgeon-defined satisfactory postoperative outcomes. The secondary aim was to identify the most effective PROM in predicting these outcomes and to evaluate the factors associated with it.</div></div><div><h3>Methods</h3><div>This is a retrospective review of prospectively collected data as part of the JUPITER multi-center study. Receiver operating characteristic curves were calculated to determine threshold values for MOI for 4 commonly used PROMs - Banff Patella Instability Instrument (BPII 2.0), Pediatric International Knee Documentation Committee (Pedi-IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Kujala score - associated with surgeon-defined satisfactory outcomes. Multivariate analyses were performed to determine preoperative, intraoperative, and radiographic factors associated with satisfactory outcomes.</div></div><div><h3>Results</h3><div>284 patients were included in the analysis. 183 (66.9 ​%) patients achieved surgeon-defined satisfactory outcomes. For MOI, achieving an improvement in BPII 2.0 score greater than 65.86 ​% (Area under the curve (AUC): 0.75; CI: 068–0.80; p ​&lt; ​0.0001) and in the Kujala score greater than 85.18 ​% (AUC: 0.69; CI: 0.62–0.75; p ​&lt; ​0.0001) was associated with a satisfactory outcome. BPII 2.0 had the highest AUC while Kujala had the least AUC (p ​= ​0.04). Multiple logistic regression analysis showed that first-time dislocation or having 10 or more dislocations prior to surgery significantly decreased the odds of achieving satisfactory postoperative outcomes (OR 0.12, p ​= ​0.002). None of the radiographic parameters were associated with outcomes.</div></div><div><h3>Conclusion</h3><div>MOI serves as an important measure to gauge clinical success after isolated MPFL-R. The study sets MOI thresholds for four commonly used PROMs, thus correlating patient- and surgeon-defined satisfactory outcomes after isolated MPFL-R. BPII 2.0 had good discriminative ability while Kujala had the least. The study identifies that isolated MPFL-R after first-time dislocation or after 10 or more dislocations are associated with decreased odds of satisfactory outcomes.</div></div><div><h3>Level of evidence</h3><div>Level 4 retrospective review of prospectively collected data.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"15 ","pages":"Article 100997"},"PeriodicalIF":3.3000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2059775425006145","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

The extent of change in Patient Reported Outcome Measures (PROMs) required to meet surgeon-defined satisfactory outcomes after isolated medial patellofemoral ligament reconstruction (MPFL-R) has not been reported. The primary aim of the study was to define the threshold value of maximal outcome improvement (MOI) in PROMs associated with surgeon-defined satisfactory postoperative outcomes. The secondary aim was to identify the most effective PROM in predicting these outcomes and to evaluate the factors associated with it.

Methods

This is a retrospective review of prospectively collected data as part of the JUPITER multi-center study. Receiver operating characteristic curves were calculated to determine threshold values for MOI for 4 commonly used PROMs - Banff Patella Instability Instrument (BPII 2.0), Pediatric International Knee Documentation Committee (Pedi-IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Kujala score - associated with surgeon-defined satisfactory outcomes. Multivariate analyses were performed to determine preoperative, intraoperative, and radiographic factors associated with satisfactory outcomes.

Results

284 patients were included in the analysis. 183 (66.9 ​%) patients achieved surgeon-defined satisfactory outcomes. For MOI, achieving an improvement in BPII 2.0 score greater than 65.86 ​% (Area under the curve (AUC): 0.75; CI: 068–0.80; p ​< ​0.0001) and in the Kujala score greater than 85.18 ​% (AUC: 0.69; CI: 0.62–0.75; p ​< ​0.0001) was associated with a satisfactory outcome. BPII 2.0 had the highest AUC while Kujala had the least AUC (p ​= ​0.04). Multiple logistic regression analysis showed that first-time dislocation or having 10 or more dislocations prior to surgery significantly decreased the odds of achieving satisfactory postoperative outcomes (OR 0.12, p ​= ​0.002). None of the radiographic parameters were associated with outcomes.

Conclusion

MOI serves as an important measure to gauge clinical success after isolated MPFL-R. The study sets MOI thresholds for four commonly used PROMs, thus correlating patient- and surgeon-defined satisfactory outcomes after isolated MPFL-R. BPII 2.0 had good discriminative ability while Kujala had the least. The study identifies that isolated MPFL-R after first-time dislocation or after 10 or more dislocations are associated with decreased odds of satisfactory outcomes.

Level of evidence

Level 4 retrospective review of prospectively collected data.
孤立髌股内侧韧带重建术后患者报告的预后改善与外科医生定义的满意结果有多大关系?木星研究。
简介:在孤立的髌股内侧韧带重建(MPFL-R)后,达到外科医生定义的满意结果所需的患者报告结果测量(PROs)的变化程度尚未报道。该研究的主要目的是确定与外科医生定义的满意术后结果相关的PROs的最大预后改善(MOI)的阈值。第二个目的是确定预测这些结果最有效的PRO,并评估与之相关的因素。方法:作为JUPITER多中心研究的一部分,这是一项前瞻性收集数据的回顾性综述。计算受者工作曲线以确定4种常用PROs的MOI阈值- Banff髌骨不稳定仪(BPII 2.0),儿科国际膝关节文献委员会(Pedi-IKDC),膝关节损伤和骨关节炎结局评分(oos)和Kujala评分-与外科医生定义的满意结果相关。进行多变量分析以确定术前、术中和影像学因素与满意结果的相关性。结果:284例患者纳入分析。183例(66.9%)患者获得了外科医生定义的满意结果。对于MOI, BPII 2.0评分改善大于65.86%(曲线下面积(AUC): 0.75;Ci: 068 - 0.80;结论:MOI是衡量孤立性MPFL-R临床成功与否的重要指标。该研究为四种常用的MPFL-R设定了MOI阈值,从而将孤立性MPFL-R后患者和外科医生定义的满意结果相关联。BPII 2.0具有较好的辨别能力,而Kujala的辨别能力最差。研究发现,首次脱位或10次以上脱位后发生孤立性MPFL-R与满意结果的几率降低有关。证据等级:前瞻性收集数据的4级回顾性评价。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.90
自引率
6.20%
发文量
61
审稿时长
108 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信